Middle Age

It hit me (briefly) today that I am now officially middle aged. It should have hit me at my last birthday when I was official middle aged, but these things take time because I rarely reflect on my age as anything other than a near random number. In a few weeks I turn 36, which also is relatively meaningless to me – I don’t really assign any value to my age so much as my state of mind, capabilities, capacity, fun, happiness and security.

The only reason this has become relevant now is because I have tendinitis in my hips, which makes moving sometimes stiff and difficult (especially if I’ve been sitting cross-legged), and means that most nights I’m waking up in pain from lying on my side (either one). This was finally diagnosed by a physiotherapist last night, and it can be fixed, but apparently it is a common ailment of middle aged women who have started going to the gym (all boxes I tick – as I don’t tick the ones about being pregnant or carrying young children on my hip). Emedicine has a helpful article which states:

Gluteus Medius Syndromeand Trochanteric Bursitis

The gluteus medius functions as a primary hip abductor. It originates at the external surface of the ilium and inserts onto the posterior lateral surface of the greater trochanter. This muscle is innervated by the superior gluteal nerve (L4-S1).The greater trochanteric bursa lies directly lateral to the greater trochanter. This lateral growth of the femur abuts the tensor fasciae latae and lateral quadriceps muscles. The bursa provides lubrication and cushioning to allow the muscles to flex and extend over the trochanter without damaging the muscles. It also cushions the tendon before the attachment of the gluteus medius and minimus. Bursitis in this area can be secondary to changes in activity or training, biomechanical problems lower down the leg, or from direct trauma. These conditions lead to increased pressure of the muscles against the bursa and trochanter—with resultant inflammation.

Pain will occur with hip flexion such as walking, climbing stairs, or getting out of a car or a chair. Nocturnal pain while lying on the affected side is common. A snap is occasionally felt or heard in the lateral hip with flexion or extension.

Gluteus medius syndrome involves tenderness to palpation of the gluteus medius muscle, which can be triggered by sudden falls, prolonged weight bearing on one extremity for long periods, activity overuse, or sporting injuries. Most commonly, this situation is observed in middle-aged women who have embarked upon a vigorous walking program or who have started working out at a health club. Patients may present with pain that is transient and worsening over a time period, a Trendelenburg gait, and weakness. These symptoms specifically affect runners, as there is tilting of the pelvis with running. It is important for the clinician to examine the patient for a leg-length discrepancy.

Hip-abduction strengthening should be avoided in the initial stages of gluteus medius syndrome because it only provokes tendinitis. As the acute stage resolves, hip-abductor strengthening is important and is best achieved in the aquatic environment. [emphasis added]

So, no hip flexing, stretches or other such fun things for me until I get better. Because it is getting worse at the moment, and if I do a Body Balance (my favourite gym class) class and do the hip flexing track, I suffer for it for a few days later. But at least I know (that and the flare up of an old lower back issue/injury) what is wrong with my body right now and that I can be put back together. It’s no fun waking up repeatedly during the night while my hips sing a song of agony, trying to find a position to sleep in that is not painful. So I have around 24 weeks of physio go to through (thankfully I have sufficient money to pay for that), 6 – 12 weeks for my spine and then another 6 – 12 weeks for my hips. And then… stuff!